That's oh-be-GUY-n, not oh-be-GIN, as some (primarily people from Texas) would like to refer to my chosen profession. Although, working in this field can sometimes cause one to develop a penchant for gin...hmmm.

Saturday, August 16, 2008

The Evolution of a Pregnancy (a conglomerate of myths and multiple patients, seen through the years)

Pregnancy is supposed to be a sort of "golden time" in a woman's life. The media tells us this in softly muted images of unblemished bellies and serene smiles. Our own family members knowingly wink and talk about how grand their pregnancies were and how "you don't remember the pain" of labor once you are holding your little (angelic and sleeping) bundle of joy in your arms. Before you become pregnant, the state of gestating a life seems almost mystical, magical, and other-worldly. It seems like somewhere you really really want to be.

Then, you take the plunge, and if you are lucky, you become pregnant. It is then and only then that you realize you've been duped! All the blissful, sighing moments you imagine in your pre-pregnant state are replaced with the bitter reality of puking your toenails up morning, noon, and night, or breasts so sore that it hurts when someone dares to *look* at them. The heartburn burns a path from stomach to esophagus so fiery, you are certain that the 9th circle of hell is cooler, and the mind numbing fatigue turns you into a zombie.

Then, your family and friends, so encouraging prior to your pregnancy, suddenly morph into this raging band of harpies...right before your very eyes! Then, the "advice" and the subtle "judgement" from all sides. Oh, I *never* got sick with *my* pregnancy. Not one time! Are you sure everything is ok? Wow, are you sure you are pregnant? You just look chubby! You don't look like you are gaining enough weight. Oh, no, no, no! You are gaining *way too much* weight! You should always... You should never... You are going to eat *that?* My husband's sister's cousin's best friend's aunt had a miscarriage because she ate too many hot dogs, you know. What was the heartrate? Oh, then it is definitely a boy/girl/fire monster. Face it, people are mean to pregnant women.

Dutifully, you make lists, and bring them to your obstetrician, who spends a good 10 minutes each session systematically de-bunking the myths and reassuring you that the soft serve ice cream that you had last week will not, indeed, turn your child into a four-headed fire monster. As for the heartbeat, naturally it is faster when the baby is smaller, and slower as the baby grows. NO, you cannot tell by the rate whether it is a boy or a girl. Truly, you cannot. You go away feeling somewhat assured, but uneasy. After all, every one you know has an opinion about your pregnancy.

Then, you reach in the second trimester, and you must endure unwanted belly rubs from strangers in the grocery line, accompanied by clucking "you are *how* far along, dear? Oh my, you are (way too big, way to small, carrying *high,* not carrying high *enough*, OMG are you sure you aren't having twins???) Then, these expert eyewitnesses will attempt to divine the sex of your child, simply by looking at the curve of your belly or the, er, thickness, of your derriere. It doesn't matter what the ultrasound says, honey, look at how big your ass is getting! That is a sure sign of a girl/boy (take your pick)! Fifty percent ofthe time, it works, every time, you know?

Rolling on to the third trimester, you start to fear how you will ever, ever get this growing baby out of your uterus, and your friends and family are now ready to regale you with the *horror* stories they've been keeping secret from you until you have reached the point of no return. Your already sleepless nights, filled with multiple bathroom visits as your precious bundle plays trampoline on your bladder, are now punctuated with fitful imaginings of epidurals that don't work, babies that get "stuck," episiotomies gone bad, and emergency cesarean sections. You turn to the internet for comfort, but instead only find more horror stories about Ob/Gyns that are only out to cut every woman that they have ever met, the evils of hospital births, and about how you should have had a midwife and a doula all along.

Alarmed, you present to your next visit, and try to determine whether or not your OB is one that will cut your belly in favor of getting home in time for dinner that night. Surprisingly, your OB seems reasonable about birthing plans and open to questions about cesarean rates and episiotomies, but you never know, the internets say to beware of medical professionals. Ultimately, you get to the final four weeks of your pregnancy, and you realize that perhaps you really don't care how the baby gets out as long as it does it soon. Your sister suggests that you should just "tell the doctor" to induce you, so you can have a Leo baby instead of a Virgo. You entertain the fantasy of asking the doctor to just "go ahead and cut it out, already," previous worries of cesarean section be damned. Your physician isn't swayed by your pleas for induction at 37 weeks. Heartless bitch.

The final week before your due date drags on. Your feet are swollen. You move like a 89 year old arthritic woman. You have the occasional contraction that makes you excited that the end of the pregnancy may be near, but nothing ever gets close enough. You visit triage once or twice, just to make sure you aren't in labor, and you get turned away, ashamed. You are tired of the "sure fire" ways to induce your labor. You've eaten enough Mexican, Chinese, and Eggplant Parmesan to induce 10 labors, but all it did for you was give you more heartburn (this kid better have some freaking hair!) You've walked the malls, rubbed your nipples raw, and had the most uncomfortable sex of your life, but there are no contractions to show for it. The due date comes and goes, and your OB tries to explain that the due date is more like a "4 week window" of when the baby is likely to come out, and not the day that you magically burst into spontaneous labor as you had been hoping. You are certain that you will be pregnant forever.

Then, one fateful night, you start to have regular, and (oh my lord) painful contractions. You begin to realize that all of the time you thought you were contracting, your uterus was just doing some minor stretching. These contractions? Hurt like hell. You arrive on Labor and Delivery with the bag you packed 5 weeks ago when you were hopeful that you were going to go early (because Aunt Melanie said she "just knew" you weren't going to make it to your due date). You are certain that you are already 8 cm dilated, because, holy hell, these contractions hurt. You are both dismayed to find that you are "only 4 cm," and relieved because you know you have reached the magical cervical dilation for admission. Your determination for a medication-free delivery wavers with each body-wracking contraction that you have. Finally, you just can't take it any more, and you "break down" and ask for the evil epidural. Only, it's too late. You are fully dilated and there is no time to do anything but push. Nothing ever felt so great and so horrible all at once. It is truly like your instincts just take over and your body works with you to finally push your baby out into the world. There's burning, stretching, tearing, grunting, and screaming, and then, relief...followed by a small cry and a warm, slippery body being laid upon your belly.

As you look down at your baby, and they look up at you, white with vernix, covered in goo, certainly not quiet or sleeping or serene, and hairless (heartburn be damned!) you know (despite what everyone else told you) with every ounce of your being that you will never, ever forget the *pain* that it took to get them here. You also know that it was worth it....all of it.

41 comments:

Anonymous
said...

Gee, I don't think I was ever quite THAT miserable. I did, however, get the grief you describe from family, friends, patients, perfect strangers (everybody's an expert), so I always try to say positive things when talking to pregnant women. Or just don't say anything at all.

I follow several "doctor" blogs, and there are some that seem to publish kind of... desperately. Is there a blogosphere version of the academic requirement to "publish or perish"? I much prefer waiting on the gestation of an excellent post -- like this one. Thanks.

Ah yes...it all sounds so familiar! Childbirth is followed by more glowing pictures of cute babies with perfect curls, rosey cheek, and porcelain skin in impeccable white outfits. So why - they ask me - does my baby have bumpy, pimply skin, cradle cap, and projectile vomit all over my dry clean only sweater. Welcome to parenthood!

just laughed and cried my way through your post! AMEN to all of it! Keep posting, I love getting a doc's view on so many things in L&D. I'm an L&D nurse at a smallish hospital in Washington state (1500 dels/yr).

Thank you for that. I've been reading for a little while now and this actually brought tears to my eyes. My husband and I have a 16 month old son and are currently 12 weeks pregnant with no. 2. Pregnancy is not the best time of you life, but the end result is definitely, beyond a shadow of a doubt worth it. So thanks for letting the pregnancy hormones out and letting me have the third or fourth cry fest of the day!

I'm curious about your adding in the horror story section that people talk about babies getting "stuck," as if that doesn't really happen. I just recently had my 6th baby and she did get "stuck." No matter how hard I tried to push her out, the nurse had to reach in and grab her out. It was scarey and confusing, especially because my dr. dropped the ball, didn't check on me like he should have (I was a gran multip, AROM, high dose of pit, and getting up frequently to use the restroom), and the nurse didn't call him when she was supposed to, oh, and yes, the epidural was *crappy*. But, I have vowed to tell those first-time pregnant ladies I know that I'm fine, my baby is fine, and "all's well that ends well", that is, if they ask. I'm not volunteering that labor story to the inexperienced and naive!

You have completely and totally nailed it. I *just* had my baby (11 days overdue) and other people were driving me CRAZY. My 'omg-you're-so-overdue-you-MUST-get-induced-like-RIGHT-NOW' baby was born covered in vernix, amidst pools and pools of clear fluid (I wasn't induced, btw). I've also come to the conclusion that society has a static image of a pregnant woman - about six months along. Big enough to look pregnant, but not big enough to be disturbing. Any smaller than this and you "don't look pregnant." Any bigger, and you are "clearly having twins."

Ok so this is the first time I have ever commented on a blog, but I have to say that this is one of the most awesome entries I have ever read. I just had my son 6 months ago and all of this is still very fresh in my mind. Very well put I love it.

ummm. the first description of pregnancy fits me. I forgot the painand actually remembered it as feeling good-and everyone around me, including my kick-ass hgme birth midwife/doctor was AWESOME.My last labor was an hour and a half and actually did feel amazing!Your blog made me feel really sad-pregnancy/birth should be a golden time.

I loved it, and that's interesting how things are alike in two different countries like yours and mine! I'm a ob/gyn in Brazil, and, as woman and physician, I've been through it all, not only the physical part, but mainly the advices, the creepy stories, the belly rubbing... And the internet, the doulas fundamentalists (not entirely out of reason in my country, I must reckon). I really loved it!!!!!

Absolutely phenomenal post. You hit the nail on the head exactly. I LOVE that you wrote the perspective of the due date as a 4-week window. One very rarely hears an OB voice that opinion, and I LOVE that this is out here on the Internet for all those people who try to instill even more fear into pregnancy women about their doctors. Sure there are terrible docs out there, but there are fabulous ones, too.

I had to LOL at parts of this post b/c they are so true!! I just had #3 a little over a month ago and if one more person said "HOW COULD YOU POSSIBLE GET ANY BIGGER"..etc. I would have had to come unglued. #3 checked in weighing 11lbs. 100z and 22.5 inches long. There's a reason I was huge folks :) Great post!Amy in OH

When I was pregnant, it was most uncomfortable when my psychotic patients would make all sorts of comments about my belly... Although there was a psychotic patient who consistently, correctly predicted the genders of all the babies, of all women who had ever been pregnant in the clinic. She even knew a social worker would have twins BEFORE the social worker found out she was having twins...

I always told patients and anyone else who asked me, "it's due in October". If they pressed me, I'd say "early October." For Pete's sake, never, never, tell anybody your due date. It just makes for headaches.

Every moment of this read was filled with memories from my other two pregnancies and the one I am currently in. I am 39wks 2 days and I am definitely ready to hurt anybody who sais to me "Girl you def. having twins you are so big" SHUT UP but of course I just smile.

Hi, I think your blog "The Evolution of a Pregnancy" is terrific, and I would like to feature you on Wellsphere (http://www.wellsphere.com). Would you drop me an email?Good health!Geoff--Geoffrey W. Rutledge, MD, PhDhttp://medblog.wellsphere.com

Six days after giving birth, I love this post! I will have to send the link to my sister, who has never been pregnant and cherishes the golden mystical view. I'm glad to have done it, but I can't say that it's an _easy_ or comfortable process!

I'm 20 weeks pregnant with twins, today, and I've never been so miserable in my life. This was supposed to be my fourth baby, so I should've known what I was getting into, but I didn't count on number 5 being crammed in there for good measure. I know I'm experiencing a miracle, but man, it hurts-and relief is so far off that I can't imagine it will ever come. Until I think of all the stuff I should be getting done to get ready for two babies...